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Potential new post-laser refractive surgery complication identified

A new syndrome characterized by noninflammatory corneal opacification can occur in some patients within 9 days after undergoing LASIK or PRK, according to a study. The opacification gradually clears over several months and can also cause a possible hyperopic shift in refraction, the study authors said.

Baris Sonmez, MD, and Robert K. Maloney, MD, identified 23 eyes of 14 patients with the syndrome, which they termed central toxic keratopathy. Four eyes had undergone PRK and 19 eyes had undergone LASIK.

In all cases, eyes developed central corneal opacification in the laser-treated area 3 to 9 days after surgery, which persisted for 2 to 18 months, the authors reported. Eighteen of the 19 LASIK-treated eyes developed diffuse lamellar keratitis before the onset of the opacification, they noted.

Nine eyes also developed hyperopia over 2 D, one eye lost two lines of best corrected visual acuity, and two eyes lost one line, according to the study The hyperopia and residual striae can be treated with an enhancement procedure, but topical or oral corticosteroid treatment is not indicated, the authors noted.

The cause of the keratopathy is not known, they added.

The study is published in the March (2007) issue of the American Journal of Ophthalmology.